First aid for stroke

Author: ambulance doctor Deryushev A.N.

Stroke is a disorder of the cerebral circulation. Arteries supplying blood to the brain may become clogged, and then an ischemic stroke occurs, or the artery may rupture and this is a hemorrhagic stroke. Thus, as a result of this vascular accident, part of the brain remains without a normal blood supply, experiences oxygen starvation. As a result of hypoxia - a lack of oxygen in the tissues, nerve cells die. This leads to a variety of neurological symptoms, it can be a complete or partial loss of speech, memory lapses, paralysis of parts of the body (hemiparesis).

Among all strokes, the ischemic variant occurs in 80% of cases. Blocking the arteries that supply the brain with oxygen-enriched blood, most often occurs as cholesterol deposits. Ischemic strokes most often occur against a background of low blood pressure and occur mostly in the morning. If the artery is not of a very large diameter, then the clinic of such a stroke develops gradually, begins with weakness, dizziness, numbness of the face, hand and / or legs on one side, visual and speech impairment may appear, the corners of the mouth become asymmetrical, , loss of balance. When occluding large diameter arteries, differential diagnosis between ischemic and hemorrhagic stroke in the prehospital stage is extremely difficult.

Hemorrhage in the brain (hemorrhagic stroke) occurs when the blood vessel ruptures and the blood surrounding the surrounding tissues is filled. This disrupts the normal flow of blood to the brain, the poured blood squeezes the brain tissue, leading to their further damage. Most often, hemorrhagic strokes occur against the background of increased blood pressure.

With a decrease in the lumen of blood vessels, which supply the brain with blood and, consequently, the deterioration of its nutrition, it is necessary to prescribe drugs that reduce blood clotting (dilution of blood) - it can be aspirin, which is used for a long time by ¼ tablets a day, or drugs newer - warfarin, in a dose , prescribed by the treating doctor. The use now finds the drug clopidogrel or zilt, which is also recommended by neurologists as a disaggregant even in the prehospital stage.

What to do

Emergency care for severe stroke at the prehospital stage does not require an exact definition of its nature (hemorrhage or ischemia). The basic principles of such emergency help consist in creating conditions for the normalization of the vital functions of the body: breathing and circulation, fighting brain edema. Disorders of breathing in the loss of consciousness can be due to violation of the patency of the airways, and therefore it is necessary to exclude the tongue lagging, vomiting of the masses into the trachea and bronchial tree, and for this the patient's head should be turned to the side. According to modern recommendations of neurologists, correction of blood pressure is carried out only if it significantly exceeds normal values, since low blood pressure in patients with stroke leads, as a rule, to a worsening of its condition and further prognosis.

The patient must provide oxygen supply, prescribe drugs that have antihypoxic effect. To date, preference is given to the drug - mexidol, which must be administered intravenously, in a dose of 5 milliliters, diluted in saline solution. Of the drugs that improve cerebral circulation, neurologists today recommend the use of a pre-hospital solution of magnesium sulphate. From application at insults of an euphyllinum now have departed and more it or him do not recommend. With the threat of cerebral edema, oxygen therapy is continued, and diuretics are prescribed (lasix). In case of seizures - anticonvulsant therapy (Relanium). The patient should be hospitalized in the vascular center, in the primary vascular department or in the nearest medical institution that has a resuscitation department, as often such patients require intensive therapy, including resuscitation.

Prevention measures are to protect the blood vessels, and this is primarily a refusal to smoke, since nothing so damages the vascular wall as components of tobacco smoke (and there are more than three hundred components!), Control and treatment of arterial hypertension, diet, regular exercise. It is worth recalling that 80% of our health, according to WHO, depends on our way of life.